Detailed Imaging Diagnosis for Early Colorectal Carcinomas─Barium Enema Study Yusuke Saitoh 1 , Motoya Tominaga 1 , Masaki Taruishi 1 , Kenichiro Ozawa 1 , Takashi Sukegawa 1 , Satoshi Suzuki 1 , Mikihiro Hujiya 2 , Masafumi Nomura 3 , Tomoyuki Ohta 4 , Jiro Watari 5 1Digestive Disease Center, Asahikawa City Hospital, Asahikawa, Japan 2Department of Gastroenterology, Hematology and Oncology, Asahikawa Medical College, Asahikawa, Japan 3Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan 4Department of Gastroenterology, Tokusyukai Sapporo East Hospital, Sapporo, Japan 5Department of Internal Medicine, Upper GI Division, Hyogo Medical University, Nishinomiya, Japan Keyword: 注腸X線検査 , 内視鏡検査 , 側面変形 , 概観撮影 pp.784-799
Published Date 2010/4/30
DOI https://doi.org/10.11477/mf.1403101935
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 Barium enema study was performed for a total 473 cases of early colorectal carcinomas as pretherapeutic detailed examination in the last 10 years. The lesion delineation rate was a satisfactory 97.5%(461/473). Overall accuracy of invasion depth diagnosis was slightly lower at 72.1% because barium enema study proceeded mainly for lesions with suspected SM cancers. Useful radiographic findings for invasion depth diagnosis that frequently appeared in SM-m cancers are as follows ;(1)Polypoid type : presence of depression surface, folds converging toward the tumor, lateral wall deformity,(2)Flat elevated type : presence of folds converging toward the tumor, LST(laterally spreading tumor): presence of depression surface, lateral wall deformity,(3)Slightly depressed type : presence of deep and/ or irregular depression surface, folds converging toward the tumor, lateral wall deformity. Therapeutic strategy on the basis of radiographic findings was as follows ; if at least one or more radiological findings is detected, the patient should be sent for surgery because the lesion may be a SM-m cancer with more than 1,000μm submucosal invasion distance, but if no radiological findings are delineated, the lesion may be endoscopically resected firstly, followed by additional surgery or not according to the histopathological findings.

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